Year Business Executive Explained for Students (Easy Guide)

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What This Question Is About

This question relates to year business executive and requires a structured academic response.

How to Approach This Question

Structure your response with introduction, analysis, and conclusion.

Key Explanation

This topic involves year business executive. A strong answer should include explanation, application, and examples.

Original Question

A.D., a 48-year-old business executive is brought to the emergency department by a co-worker. At work he started vomiting a large amount of coffee-ground emesis and requested to go to the hospital. A.D. has a 9-year history of GERD and was hospitalized with upper GI bleeding 4 years ago. At that time, blood specimens were positive for H. pylori, so he was treated with triple antibiotic therapy and uses Esomeprazole daily. His PUD has been controlled with medications since that time, but he states he has recently been under much more stress than usual because of company merger negotiations. He started smoking again after having quit for 7 years, and his alcohol consumption in the last 3 months has increased, especially when meeting with other business executives. Because of his work demands, he has not taken his medications routinely, eaten a healthy diet, or slept well. He has chronic, intermittent headaches, often relieved with Tylenol. He reports that he has had increasingly dark stools for the past week and developed severe nausea before he started vomiting this morning. He says he has no sharp pain, only mild upper abdominal discomfort and nausea, which seems to feel better after he eats. Your initial assessment reveals the following vital signs: BP 102/62 mm Hg, heart rate (HR) 98 beats/min, respiratory rate (RR) 24 breaths/min, temperature 98.0° F (36.7° C); capillary refill at 4 sec; skin cool and slightly moist, no distention of jugular veins, clear lung sounds, and a mildly distended abdomen with hyperactive bowel sounds. Top of Form Question 5 You anticipate that management of A.D.’s symptoms will include (Select All that Apply): Group of answer choices Administration of IV nitroprusside. Administration of IV pain medication Insertion of an NG tube Insertion of a central line IV fluids NPO Insertion of a naso-jejunal tube Question 9 36 hours (1.5 days) after surgery, you are once again A.D’s nurse (and thinking that it is good you have a good rapport with him because you have taken care of him a lot in the last week!). A.D. reports that he feels slightly nauseated. His abdomen is soft and only tender at his incision site. You auscultate and hear no bowel sounds. At this time, you are concerned A.D. has developed a bowel obstruction. Which type of bowel obstruction would you expect? Explain WHY. Question 10 Until A.D’s obstruction resolves, you anticipate orders for (THERE ARE 7 CORRECT ANSWERS) Group of answer choices Jejunstomy/J-Tube IV Fluids or TPN Activity: Strict Bedrest NG tube to low continuous suction Strict I/O Activity: Up with assist Regular diet NPO Chloraseptic or lidocaine throat spray IV Proton Pump inhibitor (such as Pantoprazole) Ibuprofen (Advil/Motrin) PO for pain Question 12 A couple days later, you review A.D’s labs and find the following results. Test Normal Range RESULT Sodium 135-145 mEq/L 130 mEq/L Potassium 3.5-5.0 mEq/L 3 mEq/L Chloride 96-106 mEq/L 97 mEq/L Carbon dioxide 23-29 mEq/L 28 mEq/L BUN 6-20 mg/dL 38 mg/dL Creatinine 0.2-1.0 mg/dL 0.8 mg/dL Glucose 70-100 mg/dL 65 mg/dL Albumin 3.5-5.0 g/dL 2.5 g/dL To treat AD’s abnormal labs, match the lab value to the treatment you anticipate to fix it. IMPORTANT NOTES: AD has the NG placed to suction. He is NPO due to his bowel obstruction CURRENT IV FLUIDS: 0.45% Normal Saline at 80 mL per hour Group of answer choices Potassium Increase IV infusion rate (100 mL per hour) Dextrose 50%IV Push Add potassium to IV fluids (0.9% Normal Saline with 20 meq KCl Change to 0.9% normal saline infusion BUN Increase IV infusion rate (100 mL per hour) Dextrose 50%IV push Add potassium to IV fluids (0.9% Normal Saline with 20 meq KCl) Change to 0.9% normal saline infusion Glucose Increase IV infusion rate (100 mL per hour) Dextrose 50%IV push Add potassium to IV fluids (0.9% Normal Saline with 20 meq KCl) Change to 0.9% normal saline infusion Sodium Increase IV infusion rate (100 mL per hour) Dextrose 50%IV push Add potassium to IV fluids (0.9% Normal Saline with 20 meq KCl) Change to 0.9% normal saline infusion Question 14 Five Years have passed. Yes – 5 years! You have become certified in Med/Surg Nursing (congratulations!) and are now working weekends in the Emergency Department while you work on your MSN. On a slow-ish Tuesday night you realize the next patient being worked up is you old friend, AD! He presents with nausea and vomiting. Abdomen is distended. Bowel sounds are present, slightly hyperactive. He has not had a bowel movement in 6 days. The physician suspects a bowel obstruction. What type of obstruction do you suspect? Group of answer choices Mechanical due to surgical adhesions/scar tissue Non-Mechanical post operative ileus Mechanical – intusuception Question 15 Consider AD’s symptoms, and explain why the physician (and you!) would suspect a bowel obstruction rather than Cholelithiasis. Answer like this:: If it were cholelithiasis he would…… But instead, AD………… The way these are kind of similar….. Bottom of Form

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